high gear

This is going to be a fast post! Stream of consciousness! Bear with me, here–there’s a lot to update.

I had the IUI on Saturday. As I waited for the doctor, I was again facing the calendar. I counted out the days until the due date in 38 weeks and fixed my eyes on it for minutes in a row. Eventually, the doctor appeared, and she was a young black woman with long braids whom I’d never met before. She had a warm vibe and wished me good luck. 11 million, good motility, McP never disappoints with the numbers. While hanging out for 5-10 mins, I actually started fighting off negative thinking (a big NO), and then remembered that what you resist persists. Let the anxious thoughts flow… it’s OK, and understandable. I thought about babies. Afterward, I took a picture of the exam table so the eventual baby can see where he/she was conceived, ha!

At the front desk, I went out to see Maria who is my BFF. I asked her what she thought and she said she thought things were good, and I should focus on positive thinking. She says she’s somewhat psychic, and I believe her. I asked if I could give her a hug, and she said, “of course!” and I stepped around behind the front desk and she kissed my cheek and gave me a huge hug and wished me luck. I spent much of the weekend sleeping–still sleeping off the cold and the stress of the previous week. On Monday, I felt like a million bucks at my 7am training session.

The challenging nature of this process has required me to create some really good habits. I am more organized than usual, I go to bed earlier and get up earlier, I am cooking more. It’s not that hard to avoid certain foods/drinks (coffee, alcohol, gluten). I actually meditate in the morning, at one far end of my yellow couch, facing the sunrise out the bay window. I am more in love with my friends and my city and my family than ever. I’m happy to know that I can kick into this higher gear when it’s necessary. Self-care has finally become the thing I do, religiously, instead of avoid.

Yesterday morning, I had my IVF consult with Dr. Tran–Olga scheduled it since it can take 3 weeks to get an appt with him, so might as well get that show rolling while waiting for the result of this cycle. In a word, the conversation was fascinating. I’m still incredulous that this is even possible. And, yes C, I got a little excited.

The first thing he asked me after shutting the door was, “How are you feeling?” and I paused and said, “How do you want me to answer that question?” Because, as you know about me by now, I can share a great deal of info at long stretches if not given further guidelines. He said, smiling, “It’s an open-ended question.” I said this has been hard, but I’m doing OK, and feel like I’m standing on the edge of a cliff called IVF.

That comment got him started down an alternative path, where I would continue doing IUIs but on an injectible cycle if I wasn’t ready for IVF, meaning I’d give myself daily injections to stimulate production of more follicles (4-5). At first I thought, yes–I’m maybe not ready for IVF yet. But then we talked about IVF.

Ultimately, he says, IVF will get me pregnant the quickest and be the most cost-effective. And I know he is on the conservative side…doing injectible IUIs now seems like more time on the slow path. As he said in so many words, I’ve done my due diligence. When I asked his recommendation, he said, “It’s time.”

So, what is the protocol? I’ll try to summarize in a nutshell. First, he recommends taking a month off for my sanity. I have to consider this…it was so hard for me to take a month off in November. But I know that it would feel like a vacation.

Then, on the next cycle, I’d go on birth control for 14-21 days, and do Lupron injections 2 weeks in for 10 days. This will begin to disconnect my brain from my fertility cycle–I’d go on “manual” instead of “automatic.” After the next period, I’d have 2-3 injections per day for 4 days, blood test, ultrasound, HCG trigger, 36 hours later egg retrieval under sedation.

One thing I didn’t know is that every cycle, there are 10-20 eggs that begin to develop, but they all naturally peter out with the exception of one dominant. (And the body does not self-select for the good egg, darn.) The drugs help to keep all 10-20 in the running–so you’re not actually robbing from future cycles, just maximizing the potential you already have. He would expect to “rescue” 10-20, 70% will be bigger than 13mm (7-14), fertilization would occur in 60-70%, leaving 5-10 embryos. They’d put back 3-4 for a 30% success rate with chances of twins in the low teens. Another option is going to Day 5, allowing the embryos to get much bigger and therefore able to be genetically tested–how crazy that they can biopsy such a teensy thing and know virtually everything about it. The catch here is that you automatically lose 60% by letting them go that long. You don’t have to decide which day the transfer is until you know how many you got.

Dr. T. said my questions were “very insightful”–I admitted that I pulled many of them off the SMC national discussion board. I noticed his coffee sitting nearby, from Noah’s Bagels, wondering where he lived near a Noah’s (there isn’t one near UCSF). Also wondered how he took his coffee so I could bring him one next time.

He stood up and put his hand on my shoulder on the way out, wishing me a good day. I thanked him and shook his hand. He spent 45 minutes with me, at 7:30am. I realized upon leaving that I totally forgot during the conversation that I could be pregnant now.

So, this is a lot to process. Please correct me if I got any of these details radically wrong, IVF friends. I’m in the blissful bubble of no decisions, nothing more to do.